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Characteristics of Pachychoroid Diseases and Age-Related Macular Degeneration: Multimodal Imaging and Genetic Backgrounds

1
Department of Ophthalmology and Visual Sciences, Kyoto University Graduate School of Medicine, Kyoto 606-8507, Japan
2
Department of Ophthalmology, Japanese Red Cross Otsu Hospital, Otsu 520-8511, Japan
*
Author to whom correspondence should be addressed.
J. Clin. Med. 2020, 9(7), 2034; https://doi.org/10.3390/jcm9072034
Received: 26 May 2020 / Revised: 18 June 2020 / Accepted: 26 June 2020 / Published: 29 June 2020
(This article belongs to the Special Issue Vitreo-Retinal Disorders: Pathogenesis, Diagnosis and Therapies)
The emergence of pachychoroid disease is changing the concept of age-related macular degeneration (AMD). The concept of pachychoroid diseases was developed through clinical observation of multimodal images of eyes with AMD and central serous chorioretinopathy; however, recent genetic studies have provided a proof of concept for pachychoroid spectrum disease, which should be differentiated from drusen-driven AMD. The genetic confirmation of pachychoroid concept further provides novel viewpoints to decode previously reported findings, which facilitates an understanding of the true nature of pachychoroid diseases and AMD. The purpose of this review was to elucidate the relationship between pachychoroid diseases and AMD by interpreting previous findings on pachychoroid diseases and AMD from the novel viewpoints of genetic associations. We confirmed that previous genetic studies supported the concept of pachychoroid diseases. From a genetic viewpoint, the presence of thick choroid and the presence of choroidal vascular hyperpermeability were important characteristics of pachychoroid spectrum diseases. Previous studies have also suggested the classification of polypoidal choroidal vasculopathy (PCV) into two subtypes, pachychoroid neovasculopathy and drusen-driven PCV. Genetic viewpoints will be beneficial to rearrange subtypes of drusen-driven AMD and pachychoroid spectrum diseases. Further genetic studies are needed to investigate pachyvessels, pachydrusen and the significance of polypoidal lesions in pachychoroid neovasculopathy and drusen-driven AMD/PCV. View Full-Text
Keywords: age-related macular degeneration; genetic association; indocyanine green angiography; optical coherence tomography; pachychoroid disease age-related macular degeneration; genetic association; indocyanine green angiography; optical coherence tomography; pachychoroid disease
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Yamashiro, K.; Hosoda, Y.; Miyake, M.; Ooto, S.; Tsujikawa, A. Characteristics of Pachychoroid Diseases and Age-Related Macular Degeneration: Multimodal Imaging and Genetic Backgrounds. J. Clin. Med. 2020, 9, 2034.

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